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Int. J. Environ. Res. Public Health 2013, 10(3), 808-815; doi:10.3390/ijerph10030808
Article

Outbreak of Ampicillin/Piperacillin-Resistant Klebsiella Pneumoniae in a Neonatal Intensive Care Unit (NICU): Investigation and Control Measures

1
, 2
, 3,* , 4
, 5
, 5
 and 4
1 Health Care Management, Bologna Local Health Trust, Via Castiglione 29, 40124 Bologna, Italy 2 Hospital Directorate, Bologna Local Health Trust, Maggiore Hospital, Largo Nigrisoli 2, 40100 Bologna, Italy 3 Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy 4 Hospital Directorate, Bologna Local Health Trust, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy 5 Neonatal Intensive Care Unit , Bologna Local Health Trust, Maggiore Hospital, Largo Nigrisoli 2, 40100 Bologna, Italy
* Author to whom correspondence should be addressed.
Received: 28 December 2012 / Revised: 18 January 2013 / Accepted: 16 February 2013 / Published: 26 February 2013
(This article belongs to the Special Issue Antimicrobial Resistance Prevention and Control)
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Abstract

Klebsiella pneumoniae is a frequent cause of infectious outbreaks in Neonatal Intensive Care Units (NICUs). The aim of this paper is to describe an outbreak occurred in a 13-bed NICU and the control measures adopted in order to interrupt the chain of transmission. We described the microbiological investigations, the NICU staff compliance to the infection control measures by means of a specifically designed check-list and the control measures adopted. Six cases of primary bloodstream infections sustained by ampicillin/piperacillin-resistant Klebsiella pneumoniae were observed over a two-month period. One culture obtained from a 12% saccarose multiple-dose solution allowed the growth of Klebsiella pneumoniae. During the inspections performed by the Hospital Infection Control Team, using the check-list for the evaluation of the NICU staff compliance to the infection control measures, several breaches in the infection control policy were identified and control measures were adopted. In our case the definition of a specific check-list led to the adoption of the correct control measures. Further studies would be helpful in order to develop a standard check-list able to identify critical flows in the adhesion to the guidelines. It could be used in different NICUs and allow to obtain reproducible levels of infection control.
Keywords: Klebsiella pneumonia; neonatal intensive care units; disease outbreak; infection control Klebsiella pneumonia; neonatal intensive care units; disease outbreak; infection control
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Fabbri, G.; Panico, M.; Dallolio, L.; Suzzi, R.; Ciccia, M.; Sandri, F.; Farruggia, P. Outbreak of Ampicillin/Piperacillin-Resistant Klebsiella Pneumoniae in a Neonatal Intensive Care Unit (NICU): Investigation and Control Measures. Int. J. Environ. Res. Public Health 2013, 10, 808-815.

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